RN Case Manager

Job Type

Full-time

Description

SUMMARY

The RN Case Manager is responsible for overseeing the delivery of coordinated care for a patient and / or an assigned group of patients. Additionally, this position is responsible for the day-to-day management and supervision of the related clinical care activities within the area the Case Manager services.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following : Employee must have regular attendance / punctuality, be able to work with others at all levels of the Company, have exceptional customer service, and demonstrate a comprehensive in-home clinical knowledge base. Other assigned duties include :

• Provides accurate and complete documentation with rationale to ensure reauthorization of patients.
• Field activities include tasks such as : in-home RN scheduled visits, attending physician appointments.
• Assists in the implementation of the Plan of Care ('POC') and any amendments to the POC as needed.
• Conducts the orientation of new staff and coordinates them starting in patients' homes.
• Serves as a resource to new staff for training and follow up after training to ensure staff satisfaction and retention.
• Submits all nursing documentation timely per company policy
• Completes assigned chart reviews as assigned within established time frames and follows up and councils' staff on documentation issues as necessary and ensure documentation is turned in on time.
• Establish and promote a collaborative relationship with patient, physicians, payers, and other members of the healthcare team.
• Assist authorization team to collect and communicate pertinent, timely information to payers to ensure reauthorization of patient's home health care services.
• Actively involved in the process improvement activities to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
• Participates in assigned quality assurance committee(s) and interdepartmental projects when needed or requested.
• Demonstrates current knowledge of Payor policy and procedure(s).
• Assist with state survey preparation and implementation and act as the back up administrator as assigned.
• Other duties as assigned.

SUPERVISORY RESPONSIBILITIES

This position has direct supervisory responsibilities. This position will perform supervisory visits as needed.

Requirements

QUALIFICATIONS : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required.

EDUCATION and / or EXPERIENCE

Bachelor's degree in a related field, current Registered Nurse (RN) license to practice professional nursing in each state where patient care is supervised, current Basic Cardiac Life Support certification

RELATED COMPETENCIES

Language Skills : Must be able to read, analyze, and interpret general business practices, policies and procedures, professional journals, technical guidelines, and governmental regulations. Must be able to write reports, business correspondence, and procedure manuals. Must be able to effectively present information and respond to questions from groups of managers, clients, customers, and the public. Must be able to accurately and clearly provide guidance and direction to Company staff and employees.

Business Acumen : Through the use of related law and industry data, proactively identify Company risks and institute policies and / or procedures to ensure compliance.

Decision Making : Identify and understand issues, problems, and opportunities; possess ability to analyze data from different sources to draw conclusions; utilize effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.

Other Requirements : Maintain current state licensure. Maintain current liability and malpractice insurance, if applicable.

CERTIFICATES, LICENSES, REGISTRATIONS, & MEDICAL REQUIREMENTS

CLEARANCES

The following background checks are conducted :

Salary Description

80k-90k